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Bilateral native nephrectomies for severe hypertension in children with stage 5 chronic kidney disease leads to improved BP control following transplantation

Pediatric Nephrology Sep 07, 2020

Pickles C, Kaur A, Wallace D, et al. - Since hypertension is a common problem in stage 5 chronic kidney disease (CKD 5) and after kidney transplantation (KT), researchers conducted this retrospective review to analyze the outcome of children with CKD 5 who undergo bilateral native nephrectomies (BNN) for hypertension management. The sample consisted of 134 children who underwent KT at a single centre over a 10-year period and had a minimum follow up period of 1 year. Children who had undergone BNN for hypertension before and after KT were identified and their outcome was contrasted with that of the rest of the cohort with respect to blood pressure (BP), anti-hypertensive medication and grafting feature. Eleven children (8.2%) had BNN, including 2 conducted after KT, due to poorly managed BP despite a median of 3 anti-hypertensive drugs. None of the children receiving BNN had any signs of proteinuria, and the median eGFR was 74 ml/min/1.73 m2 after KT. BNN for severe hypertension in CKD 5 is associated with a hypertension resolution before KT. It is also linked with a trend towards lower hypertension prevalence and good post-KT grafting feature.

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